Spina bifida (SB) is a serious birth defect, and is the most common of the neural tube defects (NTDs). Infants who have myelomeningocele (MM), a type of SB, often have bladder problems resulting from their SB. These problems, if not managed properly, can lead to serious kidney damage. A new protocol for bladder management for children with SB has been developed. This proposal is to evaluate the effectiveness of the bladder management protocol in newborn infants with myelomeningocele. The objectives of this project are: 1) To implement this protocol at for all newborns with MM receiving inpatient care at SCH, 2) To evaluate the effectiveness of the protocol in preventing bladder and kidney problems in the first five years of life. Newborn infants who are receiving inpatient care at SCH for myelomeningocele and have not been hospitalized before will be eligible to participate. Data will be collected for each participant at their follow up visits, using data recorded in the hospitl electronic and paper medical record. Information about the child's diagnosis, treatment, and health outcomes will be collected. Data analysis will be guided by the study coordinating committee, and will be to identify how well the protocol was implemented and how often children develop kidney and bladder problems.